Orelabrutinib Combined With Induction Therapy Followed by Sequential Monotherapy Maintenance in MCD Subtype Diffuse Large B-cell Lymphoma

June 25, 2026 updated by: Ou Bai, MD/PHD

Efficacy and Safety of Orelabrutinib Combined With Induction Therapy Followed by Sequential Monotherapy Maintenance in MCD Subtype Diffuse Large B-cell Lymphoma: a Single-center, Single-arm, Prospective Study

This is a single-center, single-arm, prospective study aimed at evaluating the efficacy and safety of orelabrutinib combined with an induction regimen followed by monotherapy maintenance in patients with MCD subtype diffuse large B-cell lymphoma (DLBCL). The primary endpoint is the 2-year progression-free survival (PFS) rate; secondary endpoints include overall response rate (ORR), complete response rate (CRR), overall survival (OS), and treatment-related adverse events (TRAEs). The study plans to enroll 66 patients.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

This is a single-center, single-arm, prospective study aimed at evaluating the efficacy and safety of orelabrutinib combined with an induction regimen followed by monotherapy maintenance in patients with MCD subtype diffuse large B-cell lymphoma (DLBCL).

Study Type

Interventional

Enrollment (Estimated)

66

Phase

  • Phase 2

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • China
    • Jilin
      • Changchun, Jilin, China, 130021
        • The First Bethune Hospital of Jilin University
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Patients of any gender, aged ≥18 years;
  • Pathologically, NGS, and imaging confirmed diagnosis of MCD subtype DLBCL (including IP-LBCLs);
  • No prior treatment history;
  • Serum creatinine ≤2 times the upper limit of normal or eGFR ≥40 ml/min;
  • Bilirubin <1.5 times the upper limit of normal;
  • Understand and voluntarily sign a written informed consent form.

Exclusion Criteria:

  • Pregnant or lactating women and women of childbearing age who are unwilling to use contraception;
  • Patients with a history of stroke or bleeding within the past 6 months;
  • Patients requiring treatment with strong CYP3A inhibitors;
  • Patients with comorbid autoimmune deficiency diseases or active hepatitis virus infection;
  • Patients with a history of organ transplantation;
  • Patients with a history of or concurrent other malignant tumors.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Orelabrutinib Combined with chemotherapy followed by monotherapy in ND MCD subtype DLBCL

For MCD subtype DLBCL (including IP-LBCLs) that have undergone two cycles of induction therapy, combine orelabrutinib treatment starting from the third cycle.

For patients with poor prognostic factors (meeting one of the following: Ann Arbor stage III/IV; IPI score 3-5; aaIPI score 2-3; high-intermediate or high-risk group per MSKCC and/or IELSG criteria), continue with two additional cycles of orelabrutinib-combined induction therapy, followed by orelabrutinib monotherapy maintenance for 2 years or until disease progression or intolerable toxicity.

For patients without poor prognostic factors, administer orelabrutinib monotherapy maintenance for 1 year or until disease progression or intolerable toxicity.
Drug: R-CHOP+Orelabrutinib
R-CHOP Regimen Rituximab: 375 mg/m², Day 0 Cyclophosphamide: 750 mg/m², Day 1 Doxorubicin: 50 mg/m², Day 1 Vincristine: 1.4 mg/m², Day 1 (maximum single dose: 2 mg) Prednisone: 100 mg, Days 1-5 Orelabrutinib 150mg QD every 21 days per cycle in Induction therapy, 28 days/cycle during maintenance therapy
Other Names:
  • Rituximab
  • Cyclophosphamide
  • Prednisone
  • Doxorubicin
  • Vincristine
  • Orelabrutinib
Drug: POLA-R-CHP+orelabrutinib
POLA-R-CHP+orelabrutinib Rituximab: 375 mg/m², Day 1 Vepoliximab: 1.8 mg/kg, Day 1 Cyclophosphamide: 750 mg/m², Day 1 Doxorubicin: 50 mg/m², Day 1 Prednisone: 100 mg, Days 1-5 orelabrutinib 150mg QD every 21 days per cycle in Induction therapy, 28 days/cycle during maintenance therapy
Other Names:
  • Rituximab
  • Cyclophosphamide
  • Prednisone
  • Doxorubicin
  • orelabrutinib
  • Vepoliximab
Drug: R-miniCHOP +orelabrutinib
R-miniCHOP Regimen Rituximab: 375 mg/m², Day 0 Cyclophosphamide: 400 mg/m², Day 1 Doxorubicin: 25 mg/m², Day 1 Vincristine: 1 mg, Day 1 Prednisone: 40 mg/m², Days 1-5 orelabrutinib 150mg QD every 21 days per cycle in Induction therapy, 28 days/cycle during maintenance therapy
Other Names:
  • Rituximab
  • Cyclophosphamide
  • Prednisone
  • Doxorubicin
  • Vincristine
  • orelabrutinib
Drug: Zuberitamab-CHOP+orelabrutinib
Zuberitamab: 375 mg/m², Day 0 Cyclophosphamide: 400 mg/m², Day 1 Doxorubicin: 25 mg/m², Day 1 Vincristine: 1 mg, Day 1 Prednisone: 40 mg/m², Days 1-5 orelabrutinib 150mg QD every 21 days per cycle in Induction therapy, 28 days/cycle during maintenance therapy
Other Names:
  • Cyclophosphamide
  • Prednisone
  • Doxorubicin
  • Vincristine
  • Zuberitamab
Drug: POLA-Hi-CHP+orelabrutinib
POLA-Hi-CHP+orelabrutinib Zuberitamab: 375 mg/m², Day 1 Vepoliximab: 1.8 mg/kg, Day 1 Cyclophosphamide: 750 mg/m², Day 1 Doxorubicin: 50 mg/m², Day 1 Prednisone: 100 mg, Days 1-5 orelabrutinib 150mg QD every 21 days per cycle in Induction therapy, 28 days/cycle during maintenance therapy
Other Names:
  • Cyclophosphamide
  • Prednisone
  • Doxorubicin
  • orelabrutinib
  • Vepoliximab
  • Zuberitamab
Drug: Hi-miniCHOP +orelabrutinib
Hi-miniCHOP Regimen Zuberitamab: 375 mg/m², Day 0 Cyclophosphamide: 400 mg/m², Day 1 Doxorubicin: 25 mg/m², Day 1 Vincristine: 1 mg, Day 1 Prednisone: 40 mg/m², Days 1-5 orelabrutinib 150mg QD every 21 days per cycle in Induction therapy, 28 days/cycle during maintenance therapy
Other Names:
  • Cyclophosphamide
  • Doxorubicin
  • Vincristine
  • orelabrutinib
  • Zuberitamab
  • Prednisone,
Drug: RMTO
RMTO Regimen Rituximab: 375 mg/m², Day 1 Methotrexate: 3.5 g/m², Day 2 Thiotepa 30 mg/m² Day 4 Orelabrutinib: 150 mg, Days 1-21 every 21 days per cycle in Induction therapy, maintenance therapy 28 days/cycle
Other Names:
  • Rituximab
  • Methotrexate
  • Thiotepa
  • orelabrutinib
Drug: HiMTO
HiMTO Regimen Zuberitamab: 375 mg/m², Day 1 Methotrexate: 3.5 g/m², Day 2 Thiotepa 30 mg/m² Day 4 Orelabrutinib: 150 mg, Days 1-21 every 21 days per cycle in Induction therapy, maintenance therapy 28 days/cycle
Other Names:
  • Methotrexate
  • Thiotepa
  • orelabrutinib
  • Zuberitamab
Drug: Pola-R-miniCHP+O
Pola-R-miniCHP Regimen Polatuzumab vedotin: 1.8 mg/kg IV, Day 1 Rituximab: 375 mg/m² IV, Day 1 Cyclophosphamide: 400 mg/m² IV, Day 1 Doxorubicin: 25 mg/m² IV, Day 1 Prednisone: 40 mg/m² PO, Days 1-5 every 21 days per cycle in Induction therapy, maintenance therapy 28 days/cycle
Other Names:
  • Rituximab
  • Cyclophosphamide
  • Prednisone
  • Doxorubicin
  • Polatuzumab vedotin
Drug: Pola-Hi-miniCHP
Pola-Hi-miniCHP Regimen (21-day cycle, up to 6 cycles) Polatuzumab vedotin: 1.8 mg/kg IV, Day 1 Zuberitamab: 375 mg/m² IV, Day 1 Cyclophosphamide: 400 mg/m² IV, Day 1 Doxorubicin: 25 mg/m² IV, Day 1 Prednisone: 40 mg/m² PO, Days 1-5 every 21 days per cycle in Induction therapy, maintenance therapy 28 days/cycle
Other Names:
  • Cyclophosphamide
  • Prednisone
  • Doxorubicin
  • orelabrutinib
  • Zuberitamab
  • Polatuzumab vedotin

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
2year PFS
Time Frame: From the start of treatment up to 2 years
The percentage of subjects who had not experienced disease progression or all-cause death at 24 months from first dose, relative to the total enrolled population.
From the start of treatment up to 2 years

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
ORR
Time Frame: From the start of treatment up to 2 years
The proportion of patients who achieved a PR or better response at the end of therapy
From the start of treatment up to 2 years
CRR
Time Frame: From the start of treatment up to 2 years
Proportion of patients achieving CR at the end of treatment
From the start of treatment up to 2 years
OS
Time Frame: From the start of treatment up to 2 years
Time from treatment initiation to death from any cause
From the start of treatment up to 2 years
AEs
Time Frame: From the start of treatment up to 2 years
All adverse medical events that occurred after the initiation of treatment
From the start of treatment up to 2 years

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Ou Bai, MD/PHD

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

June 16, 2026

Primary Completion (Estimated)

December 31, 2029

Study Completion (Estimated)

December 31, 2031

Study Registration Dates

First Submitted

June 22, 2026

First Submitted That Met QC Criteria

June 25, 2026

First Posted (Actual)

July 1, 2026

Study Record Updates

Last Update Posted (Actual)

July 1, 2026

Last Update Submitted That Met QC Criteria

June 25, 2026

Last Verified

June 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 25K405-001

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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